The most dangerous effect of cervicitis is the danger of development of Cervical Cancer especially with human papilloma virus infection.

What is Cervicitis?

Cervicitis is medical non-specific infection of the cervix.

Cervicitis is a red swelling (inflammation) of the cervix – the lower part of the uterus that passes about one inch into the vaginal canal.

It is most frequent on the posterior cervix but may be anterior or concentric.

Cervicitis is probably the most frequent of all gynecological disorders, involving 50% of all women at some time in their lives.

A woman, regardless of age, who has ever had one sexual intercourse and who is now having abdominal pain or an abnormal discharge from the vagina, may have cervicitis.

Even though it is so frequent, cervicitis is not easily self-diagnosed, because its symptoms can be similar with those of other frequent ailments, such as vaginitis.

If not treated, cervicitis can lead to infertility problems conceiving or having a healthy baby.

But cervicitis can be diagnosed easily by the doctor and correctly treated with a wide variety of medicines and treatments.

Prolonged cervicitis may cause problems for a woman to become pregnant and affect fertility.

The abnormal production of mucus in the cervix area may interfere with the sperm’s ability to enter the cervical canal

Also the infection can also extend to the uterus or the fallopian tubes that lead to the ovaries.

A pregnant woman with cervicitis is more likely to have a miscarriage, premature delivery, or infection of the newborn during delivery which can result in pneumonia, a severe eye infection, or blindness.

Who are at risk of having Cervicitis?

1 .Congenital cervical erosions or cervicitis can be present in virgins.

All sexually active women

Dilatation may be induced in labor or during abortion

Risks are:

High-risk sexual behavior

History of STIs

Many sexual partners

Sex (intercourse) at an early age

Sexual partners who have involved in high-risk sexual activities or have had an STD

Bacteria (such as staphylococcus and streptococcus) and over growth of usual bacteria in the vagina (bacterial vaginosis) can also cause cervicitis.

What are the types of Cervicitis?

Simple:

When the erosion surface is smooth

Papillary:

When the erosion surface is not smooth, rougher

Follicular:

When the erosion surface is cystic

What are the causes of Cervicitis?

Cervicitis is most frequently induced by an infection that is caught during sexual activity.

Most commonly, cervicitis is due to an infection, although it can also be caused by trauma or irritation (allergic reaction to the chemicals in contraceptives and vaginal douches, or a tampon that had been left behind).

Cervicitis is only one of the many problems that these diseases induce.

A number of other organisms, such as streptococcus, staphylococcus, enterococcus, herpes simplex, and Gardnerella vaginitis, can also cause cervicitis.

Bacterial infections:

Gonorrhea and Chlamydia

Trichomoniasis

Staphylococcus aureus

Streptococcus

Mycobacterium tuberculosis.

E.coli

Viral infections:

Genital herpes

Human papilloma virus (or genital warts)

Other causes:

Cervical cap (to prevent conception)

Device to support any prolapse of uterus (pessary)

Diaphragm

Allergy to spermicides used for birth control

Allergy to latex in condoms

Exposure to a chemical danger

Cervicitis is very common

It affects more than 50% of all women at some time during their adult life.

What are the symptoms of Cervicitis?

There may not be symptoms.

Women at risk for chlamydia infection should be tested for this infection even though they may not have symptoms

At the mildest form, no symptoms may be observed, but a more serious patient with cervicitis can induce a profuse, pussy vaginal discharge with an uncomfortable odor, together with severe vaginal itchiness or abdominal discomfort.

The first symptom of cervicitis tends to be a vaginal discharge that becomes more pronounced immediately after a menstrual period.

If the infection gets into the blood system, the woman may also have fever and nausea.

Unusual Mucopurulent vaginal discharge (Gray, white, or yellow color) with odor that does not go away

Other signs are itching, bleeding, or irritation of the external genitals; painful intercourse; a burning sensation during urination; and lower back pain.

Abnormal Blood in the vaginal discharge

After intercourse

After menopause

Between periods

Urinary tract infection symptoms – frequency and pain

Hematuria (blood in the urine)

Pelvic pain

Backache

Painful sexual intercourse

Pain in the vagina

Pressure or heaviness in the pelvis

Signs:

Reddened region of cervix

Eroded cervical wall

Vaginal surface of cervix may be involved

Pussy discharge from the lining of the cervix

Swelling (inflammation) of the walls of the vagina

Vaginal examination with Pap’s smear of cervical cells

Cervical swab for culture and sensitivity to antibiotics

Blood tests (white cell count, blood culture, chlamydia, gonorrhea)

How is Cervicitis diagnosed?

Diagnosis of cervicitis is accomplished through a knowledge of clinical history and a pelvic examination with direct view of the cervix.

A pap smear and culture for causative organisms is typically performed.

A pelvic examination is done to look for:

Discharge from the cervix

Redness of the cervix

Swelling (inflammation) of the walls of the vagina

Tests that may be done include:

Inspection of the discharge under a microscope (indicate candidiasis, trichomoniasis, or bacterial vaginosis)

Pap smear

Tests for gonorrhea or chlamydia

Rarely, colposcopy and biopsy of the cervix is necessary

What are the complications of Cervicitis?

Cervicitis may last for months to years.

Cervicitis may lead to pain with intercourse (dyspareunia).

Pelvic inflammatory disease

Urethritis and cystitis

Rarely malignant changes in cervix

Inguinal lymphadenitis

What is the treatment of Cervicitis?

If the diagnosis is chlamydial cervicitis, the doctor will probably prescribe a broad-spectrum antibiotic.

Among the most frequently prescribed treatments prescribed are doxycycline and other medicines that kill bacteria in the vagina and cervix.

Antibiotics are given to treat bacterial infections (such as chlamydia, gonorrhea, and others).

Medicines called antivirals may be given to treat herpes infections.

Hormonal therapy (with estrogen or progesterone) may be given in women who have reached menopause.

If a woman have prolonged or repeated bouts of cervicitis, the doctor may recommend a procedure focused on killing off the abnormal cells on the surface of the cervix.

When these treatments have not worked or when cervicitis has been present for a prolonged period, treatment may include:

The most common of these procedures are cautery, cryosurgery, and laser treatment.

After treatment, cells from untreated normal tissue normally will grow into and replace the area of damaged, abnormal tissue.

Cautery, which normally produces mild to moderate pain, tends to be less recommended than the other two newer treatments, if available.

The success rates are the same for laser and cryosurgery.

Cryosurgery (freezing)

Electrocauterization

Laser therapy

Acute Cervicitis

Antibiotics are given according to its sensitivity and resistance of bacteria in the culture.

Pelvic pain and backache may be relieved with paracetamol

Local application of tetracycline, sulphonamide, or other antibiotic cream

Cauterization of the affected cervical area

Cryosurgery

Cone biopsy if necessary.

Hormonal therapy (given in postmenopausal women)

Laser therapy

Laser treatment is indicated when there are bigger regions of abnormal mucosa.

Complete recovery may involve 6 to 8 weeks.

What is the prognosis of Cervicitis?

Most of the time, simple cervicitis normally recovers with treatment if the cervicitis cause is found and there is a treatment for that cause.

The outcome with proper treatment and correct antibiotics is normally good.

Recurrence is common.

Cervicitis may last for months to years.

How to prevent Cervicitis?

Avoid sexual intercourse with multiple partners.

Use condoms during sexual intercourse.

Vaccination against human papilloma virus

Avoid chemical irritants such as douches and deodorant tampons.

Avoid using spermicidal contraceptives

Make sure that any foreign objects that are inserted into the vagina are clean or sterile.

Things you can do to reduce the risk of cervicitis include:

Chemical irritants should be avoided such as douches and deodorant tampons.

Any foreign objects inserted into the vagina (such as tampons) are hygienic and properly placed.

Instructions must be followed on the duration, frequency, or cleansing of it.

A monogamous sexual relationship should be with a partner who is known to be free of any STI

Monogamous means the woman and her partner do not have sex with any other people.

Abstinence (No sexual intercourse) is the best way of preventing sexually transmitted cervicitis.

Using a condom at each sexual encounter lowers the danger of getting an STI.

There are condoms available for both men and women, but most of them are worn by the man.

Mastitis is inflammation or infection of the breasts, resulting in pain and swelling.

What causes Mastitis?
————————

The causes of Mastitis are mostly due:

A.Hormonal:
———————-

1.In babies whether male or female, the painless swelling of the breast may occur due to the effects of the mother’s female hormones.The swelling usually subsides after a few weeks.

2.At Puberty for girls the development of breasts may cause some pain and swelling. It may occur first on one side and then subsequently on the side.
The nipples may be red and tender andthis may cause worry for the adlolescent girl and her mother.

3.Premenstrual pain and swelling of breasts may occur

B.Infections:
———————

Infections of the breasts may occur due to
1.poor skin hygiene

2.Injuries or wounds allowing microganism to enter the wound

3.Breastfeeding as a result of the baby sucking the nipple incorrectly or as a result of blockage of the milk ducts. In either case bacteria can enter through the injured nipple or the inflammation of the blocked milk ducts may cause suppuration and abscess formation.

4.Mastitis may occur as a rare complication of mumps.

5.Most common bacteria infection is staphyloccus aures.

6.Other rare causes of mastitis are tuberculosis, syphlis or actinomycosis

What are the symptoms of Mastitis?
————————————-

The Symptoms of Mastitis are:

1.Pain usually present in all cases except in babies

2.swelling of the breasts or the nipple area

3.Pus discharge from the nipple

Signs:

1.redness of the nipple or areola

2.red, warm swelling of the breast tissue may indicate presence of formation of abscess.

3.Local tenderness of inflammed area

4.Fever and genral malaise

5.Axillary lymph nodes may be swollen and painful

What are the complications of Mastitis?
————————————

1.Abscess formation

2.Cystic formation

3.Chronic mastitis or fibroadenosis

How is diagnosis of Mastitis confirmed?
——————————————

1. clinical features

2. Mammograms to exclude malignant tumors

3. Ultrasound scan of the breasts

What is the treatment of Mastitis?
————————————

1. antibiotics are given to cure the infections.
The antibiotics may need to be taken for 10 days by mouth.
They must not be stopped just because the discomfort stops, or the infection will NOT be cured.

2. Painkillers may be given if there is pain

3.Rest and support of the breasts with soft bras

4.Warm water bottle to apply to areas of inflmmation due to blocked milk to soften the milk and induce flow.

5. surgery with drainage of abscess if antibiotic do not work.
Aspiration of cysts may also be nessary

6.Reassurance in hormonal cases of mastitis

What is the Prognosis of Mastitis?
————————————

Most cases of mastitis usually will recover with proper treatment.

What are the Preventive measures for Mastitis?
—————————————————-

Practice good personal and skin hygiene
Wash hands frequently
Clean the beasts properly before and after breastfeeding
Patients should be taught to do breast self examination and to do it frequently

His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog afamilydoctorstale.blogspot.com.

This autobiolographical account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Conditions” into a new WordPress Blog “A Simple Guide to Medical Conditions” on https://kenmed.wordpress.com

From which many free articles from the blog was taken and put together into 600 amazon kindle books and some into Smashwords.com eBooks.

He apologized for typos and spelling mistakes in his earlier books.

He will endeavor to improve the writing in futures.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical conditions.

He has published 600 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.

The purpose of these simple guides is to educate patient on health conditions and not meant as textbooks.

He does not do any night duty since 2000 ever since Dr Tan had his second stroke.

His clinic is now relocated to the Bouna Vista Community Centre.

The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.

He is now doing some blogging and internet surfing (bulletin boards since the 1980’s) starting

with the Apple computer and going to PC.

All the PC is upgraded by himself from XT to the present Pentium duo core.

The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.

He is also into DIY changing his own toilet cistern and other electric appliance.

His hunger for knowledge has not abated and he is a lifelong learner.

The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.

This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.

Dr Kee is the author of:

“A Family Doctor’s Tale”
“Life Lessons Learned From The Study And Practice Of Medicine”
“Case Notes From A Family Doctor”
“The Amazing Story of the Cold Sore Virus”